Healthcare Provider Details

I. General information

NPI: 1962225383
Provider Name (Legal Business Name): MARI ESTATE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2024
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1440 W TAYLOR ST STE 1973
CHICAGO IL
60607-4623
US

IV. Provider business mailing address

1440 W TAYLOR ST STE 1973
CHICAGO IL
60607-4623
US

V. Phone/Fax

Practice location:
  • Phone: 872-261-2511
  • Fax:
Mailing address:
  • Phone: 872-261-2511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code347B00000X
TaxonomyBus
License Number
License Number State

VIII. Authorized Official

Name: MS. ALMARIO S CRAWFORD
Title or Position: PRESIDENT
Credential: LCSW
Phone: 872-261-2511